Group psychotherapy reduces depressive symptoms but does not prevent depressive disorders among older adults

Krishna M, Honagodu A, Rajendra R, et al. A systematic review and meta-analysis of group psychotherapy for sub-clinical depression in older adults Int J Geriatr Psychiatry. 2013;29: 881-88.

Review question

Does group psychotherapy prevent depression among older adults with some depressive symptoms but who have not been diagnosed with major depression?

Background

Sub-clinical depression is a condition in which a person has 1 to 4 depressive symptoms but does not meet the clinical definition of a depressive disorder.

Symptoms include difficulties sleeping, changes in appetite, restlessness, lack of energy, inability to concentrate or make decisions, feeling worthless, and recurrent thoughts of death or suicide.

Group psychotherapy has been shown to be nearly as effective as individual treatment, is less costly, and has been shown to be well-suited to older adults.

How the review was done

This is a summary of a systematic review of 4 randomized controlled trials. The included studies were conducted between 2006 and 2009 and involved 309 adults over the age of 55.

Group psychotherapy was compared with no treatment, usual care, group education, and computerized cognitive behavioral therapy.

Outcomes included depressive symptoms and cases of major depression, and these were measured immediately after the intervention as well as 3 to 14 months later.

What the researchers found

Group psychotherapy has a significant effect on depressive symptoms compared to no treatment when symptoms are assessed immediately after the intervention. This effect is no longer observed 3 to 14 months later.

Group psychotherapy is no more effective than computerized cognitive behavioral therapy or group education.

There was no difference in the number of cases of major depression between the intervention and control groups.

Conclusion

Group psychotherapy has a significant effect on depressive symptoms in depressed older adults compared to no treatment, but this is not maintained at follow-up, and is not more effective than other interventions. Group psychotherapy does not prevent major depressive disorders.